Evaluating Kvaal’s Dental Age Estimation Method: A Cross-sectional Study on Its Accuracy and Limitations in an Indian Adult Population

Dental age estimation is an integral component of forensic identification and medico-legal investigations. Kvaal’s method, based on the radiographic assessment of regressive dental changes, is widely used in adults; however, its accuracy varies across populations and age groups. To evaluate the accuracy and reliability of Kvaal’s dental age estimation method in an Indian adult population and to assess its performance across different age groups and sexes. A cross-sectional study was conducted at Jawaharlal Nehru Medical College, Belagavi, from August 2023 to August 2024. The study included 200 adults (100 males and 100 females) aged 20–80 years. Digital periapical radiographs of permanent maxillary central incisors were analysed using Kvaal’s method, focusing on pulp-to-tooth measurements reflecting secondary dentin deposition. Estimated ages were compared with chronological ages using descriptive statistics, paired t -tests, intraclass correlation coefficients and Lin’s concordance correlation coefficient. The mean chronological age was 48.7 ± 14.5 years, while the mean estimated age was 46.5 ± 12.3 years, showing an overall underestimation of −2.65 years. Higher accuracy was observed in the 20–50-year age group, with significant underestimation in individuals above 60 years. The Lin’s concordance correlation coefficient demonstrated good agreement overall (0.82), with higher reliability in males (0.84) compared to females (0.81). Kvaal’s method provides reliable age estimation in younger and middle-aged Indian adults but demonstrates reduced accuracy in elderly individuals. Population-specific modifications and integration of advanced imaging and analytical techniques may improve age estimation in older age groups.